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00:06For most of history, doctors had no way to stop pain.
00:11Hey.
00:11Hi.
00:12Hi.
00:13I know I said you couldn't have a chocolate croissant, but they were out of bagels, so you're welcome.
00:20Is everything okay?
00:21Oh, look, Sam's mom's here.
00:24Have fun at camp.
00:25Yeah, see you later.
00:27What was that about?
00:28I'll tell you when it's ready.
00:31Seriously?
00:32During surgery, patients felt every cut and stitch until they inevitably passed out.
00:39What are you doing?
00:41It's my chief resident dance.
00:42Oh, you know this job is nothing to dance about.
00:44It is when you assign yourself a cutting-edge transplant surgery.
00:48Ah.
00:49Oh, hey, I'm excited to be working with you today.
00:51It's going to be groundbreaking.
00:52We'll see.
00:54Hey, good morning.
00:56Hey, looking forward to joining you in the OR today.
00:58Oh, is that why you're so chipper?
01:01For sure.
01:01I just parked in the chief's parking space.
01:04Isn't that the space just next to your old one?
01:06This one doesn't have a dip in the ass wallet.
01:09Mm-hmm.
01:09It's the perks of being a chief.
01:11They're mighty fine.
01:12Yeah, I've done both those jobs, so I know that chiefing is mostly scheduling and HR issues
01:20like being buried in paperwork.
01:22Um, does the chief resident still have his own desk?
01:25Already got it stocked with snacks.
01:27That's what I'm talking about.
01:28Hit the bulk store and everything.
01:30All a surgeon could do to minimize pain was work faster.
01:33That all changed when the first surgery was performed using ether as anesthetic.
01:39Morning, bench warmers.
01:42He's just jealous because he doesn't get to scrub in on the double lung transplant today?
01:46Au contraire.
01:47I am on plastics.
01:48Since when were you interested in that?
01:50Oh, huge scope and range in terms of anatomy, cutting-edge research opportunities, high demand.
01:56I think plastics might be the one.
01:59I hope you and plastics are very happy together.
02:01Now surgeons faced a new dilemma.
02:04If a patient can't feel pain...
02:06Excuse me?
02:07When do you stop?
02:08Are we assigned to cubby?
02:10Your first day?
02:11I missed the actual first day.
02:13Pre-planned vacation for my grandparents' anniversary.
02:16Bold for an autotroph.
02:20Bottom of the food chain.
02:21Intern locker rooms down the hall.
02:23Sorry, but I'm not...
02:24Hey, pro tip.
02:24If excuses make it worse, your resident will thank me.
02:29Oh, really?
02:30Trust me.
02:31Who do you have?
02:33Kwan.
02:35Well, I guess I'll have to thank myself.
02:37What'd you say your name was?
02:39Mohanty.
02:41Kavita Mohanty.
02:43Yep.
02:43I don't see you on my roster.
02:45That's because you're on mine.
02:47I'm the new plastics fellow.
02:49You're on my service.
03:01Dr. Griffith, hey, uh...
03:03How does an intern get in on this insane double lung transplant?
03:07I don't make the assignments.
03:08Talk to Warren.
03:09I'll send you late.
03:11But you can put in a good word for me, though, right?
03:12No, you don't get to ask me favors.
03:14Go make yourself useful.
03:17Wow.
03:18What'd he do to you?
03:21We need to make a pact.
03:22Uh-huh.
03:23We're second years.
03:24We need to focus.
03:25No sex, no relationships.
03:27You with me?
03:32You had sex with him.
03:34It was an accident.
03:36How?
03:37Did you fall on it?
03:38The logistics don't matter.
03:40Are you in?
03:40Oh, I'm not the one sleeping with an intern.
03:42I'm in.
03:43I'm in.
03:45Dr. Peguero for the NICU.
03:47Dr. Christina Peguero for the NICU.
03:49Hey, hey, do you know anything about cars?
03:52Should I get the extended warranty?
03:55Well, I mean, it depends on the car, your budget,
03:57how long you plan on keeping it.
03:59My lease is up in 12 hours.
04:00Wow, you've cut it close.
04:01We need a bigger car, but I hate negotiating.
04:04I thought Link would be out of the hospital
04:06and then he could handle it, but...
04:07Well, I spent the last year negotiating
04:09every penny for this hospital.
04:11You just have to be patient and clear on what your goals are.
04:13Anything is possible.
04:15You know, last month, I got an MRI machine at cost.
04:18Do you want to go with me?
04:20Uh, I have patients, but...
04:22Hey, you.
04:23Hi.
04:24In a minute.
04:25How is everything?
04:27Good, I'm great.
04:28What are you doing here?
04:29David left his wallet at home.
04:31How was your pineapple pizza?
04:32Uh, pizza?
04:34Ran into Owen and the kids last night picking up dinner.
04:36I admit I was a little judgmental when I heard your order.
04:39Oh, yeah, I was working late.
04:40Big, big, big trauma.
04:41Just, I didn't get home before they devoured everything.
04:44Oh.
04:47Well, hi, we haven't met.
04:48Oh.
04:49I'm Joe Wilson.
04:50Hi, Cass.
04:51Sorry, um, Joe Wilson, um, Cass, uh, Beckman.
04:54Um, she's just an incredible, uh, trauma surgeon.
04:58Uh, she's married to David.
04:59Oh, yeah, I've worked with David.
05:00He's great.
05:01Can't remember his wallet to save his life, but he does an excellent cabbage.
05:04Yeah.
05:05Um, this is me.
05:07Nice to meet you, Joe.
05:08Mm-hmm.
05:10I'm really glad I ran into you.
05:15So, we'll take your car?
05:22Hey, hey, I hear we're playing musical chairs with some lungs today.
05:25Oh, shoot, I'm sorry.
05:26I must have the wrong room.
05:27I'm looking for Ryan Delgadillo.
05:29It's about this high.
05:30He loves airplanes.
05:31It's me.
05:32What?
05:32It's you?
05:33You must have grown, like, six inches since the last time I saw you.
05:36I'm in kindergarten.
05:38You're in kindergarten.
05:39Wow, that's big kid stuff right there.
05:40Uh, you've all met Dr. Ndugu?
05:42He recently pioneered a breakthrough cardio surgery.
05:45We're lucky to have him.
05:46Hey, I'm happy to help.
05:47Uh, Dr. Griffith?
05:48Ryan Delgadillo, age six.
05:50Diagnosed with bronchiolitis obliterans at age two.
05:52He's been on ECMO for four weeks.
05:54Today, we will be performing a bilateral lung transplant from living donors.
05:58Each parent is donating one lower lobe.
06:00Transplanted together, they will act as Ryan's new lungs.
06:03You're sure this is the right way to go?
06:05We shouldn't wait longer for a pair of lungs from a deceased donor.
06:08Do you have any second thoughts?
06:09About me?
06:10No.
06:11I'd give Rai all my lungs if I could.
06:19Can we have a moment?
06:20Of course.
06:22Okay, and how's this is comfortable?
06:24Yeah.
06:26We just want to make sure that small pieces of our lungs are as good as a full set from
06:30someone his own size.
06:31It's a valid concern.
06:32Look, getting two lungs from a deceased donor, it's preferable.
06:36But we haven't found a match.
06:37And Ryan's been on ECMO for weeks now, and the risks of bleeding, blood clotting, organ
06:42damage, they've all quadrupled.
06:43Our window to act is closing.
06:46And, uh, you think it'll work?
06:48Based on the extensive workouts we've done on all of you, we do.
06:52Once you sign the consent forms, we can get you prepped for surgery.
07:10Okay, where do you want me?
07:12There is fine.
07:15All right, with one of these rigs, that's my patient.
07:17Who's your patient?
07:18Katie.
07:19Katie Rogers, 27, auto versus tree.
07:21Restrained passenger, negative LOC, GCS 15, moving all extremities, minor scrapes and
07:26bruises.
07:27Dr. Bailey, can I still do chemo today?
07:29Okay, we need to examine you first.
07:31She also has stage two gastric cancer.
07:33If I can't, can you still operate next month?
07:35One step at a time.
07:37Let's get her inside.
07:39Hey, move.
07:40I'm all good.
07:40Out of the way.
07:41My bag.
07:42I need my laptop.
07:43Um, Adams Bryant, go find it.
07:46Keep going, I got this.
07:47I don't mind taking a look at the rig.
07:49You're not on a tour.
07:50Did I do something to piss you off?
07:52Yeah.
07:53You slept with my girlfriend.
07:56Slep.
08:10Cass Beckman seems nice.
08:12Yeah.
08:12She's great.
08:13What about something like this?
08:15Nah, it's small.
08:16What was the big, big trauma?
08:17I was on call last night.
08:19I didn't hear about it.
08:19Oh, it must have been another night.
08:21What about the one outside?
08:22Oh, wait.
08:23Oh, this is perfect.
08:26This is going to be way out of your budget.
08:28No, but you have all that negotiating experience, and you said yourself, anything is possible.
08:32Please don't make me drive a minivan.
08:33Can I help you, ladies?
08:36Can we test drive this car?
08:38Sales manager, test out.
08:40BP is 122 over 68.
08:42Heart rate is hitting in the low hundreds.
08:44It feels easy.
08:45Uh, you might be dehydrated.
08:47Let's hang another bag of fluids and give her something for the pain.
08:50So what happened?
08:51You're right, Cher.
08:51I had a chance encounter with the tree.
08:54Yeah, these injuries don't look as nice as that sounds.
08:56Well, I'm a couple's therapist, so I'd like to put a positive flip on first meetings.
09:00Hold it.
09:00She's tender.
09:04Pre-fluid in the splinterino recess?
09:07That doesn't sound like a stop on a road to cancer-free, though.
09:10Should I be worried?
09:11What do I always tell you?
09:12Don't worry until you look worried.
09:14All right, uh, Adams Bryant, get her to CT and page me when the scans are up.
09:19Uh, Dr. Bailey, I can take her myself.
09:22Bryant can go with you.
09:23Uh, do I look like his resident?
09:25Yeah, but he'll learn more with you.
09:27Of course he will.
09:28But then you won't learn to teach.
09:33Mr. Lee, how are we doing today?
09:36I'm the same as yesterday, but you don't look like Dr. Kaise.
09:40He was pulled into an emergency case.
09:42I'm Dr. Mohanty.
09:44This is Dr. Kwon.
09:45We'll be your doctors today.
09:48Ray Lee, 35, presenting after skull injury while hiking.
09:51Technically camping.
09:52I just finished Storm King.
09:543%, TBSA partial thickness burns affecting left forearm.
09:58Status post bedside debridement and skin grafts.
10:01Post-op, day one.
10:02Can we take a look?
10:04Be my guest.
10:06Uh, no, Dr. Mohanty is a plastic surgery fellow.
10:09She is very experienced and accomplished.
10:12Sorry about that.
10:13It's an honest mistake.
10:14Anyone can make it.
10:16She's so youthful.
10:18In a good way.
10:19Not that she's old.
10:20I think he gets it.
10:23Let's remove the dressing, shall we?
10:25I'm guessing this makes the last time I make mac and cheese on a camp stove.
10:29This was a cooking accident?
10:31I'm the punchline in those jokes about cooks who can't boil water.
10:39Looks like it's healing appropriately.
10:41Dr. Kwan will redress it for you, and I'll check back in a bit.
10:46I forgot to ask if I can have some crackers.
10:48Can we page her?
10:49Let's not bother her for a snack.
10:52What do you want?
10:53Grams or saltines?
11:00All right, starting your scans.
11:02Hold still.
11:16I didn't know.
11:17Whatever.
11:25Hello?
11:26Is anybody there?
11:28Yeah, we're here.
11:29Everything okay?
11:30Yeah, it's just, it's quiet.
11:32Seemed like a bad sign.
11:35Everything's fine.
11:36We're just waiting on your scans.
11:37Okay.
11:38I'm used to listening to people talk all day.
11:41Cheating husband, wife who resents giving up her career.
11:45You know, it's my job to help people communicate.
11:49Like, in my work, talking is good.
11:51Screaming, crying, it's all fine.
11:53It's only when my clients go silent.
11:57That's when I can't help them.
11:59But I guess that doesn't happen here.
12:05Nope.
12:12Hey.
12:13Yeah.
12:13Good for the mill and filled me in.
12:15You want me on the dad's?
12:16Yeah, Kim's flight got canceled, so now he's stuck in Florida.
12:19Are you okay being my assist?
12:21Of course, but you owe me.
12:22Yes.
12:23Does Bailey have a girlfriend?
12:24I'm not answering that.
12:25Boyfriend?
12:26He has me not to say anything.
12:27You want me to break his trust?
12:28I do.
12:29You're unbelievable.
12:30I'm his mother.
12:31Okay.
12:31Hey.
12:32Hey.
12:32Weber and Warren got held up, but we should get started with the album.
12:34Okay.
12:35What are we looking at?
12:36Three lungs.
12:37Two healthy.
12:37One with extensive mosaic perfusion and air trappings.
12:40Looks like bronchiolitis obliterans.
12:42Technically true.
12:43Not the answer I'm looking for.
12:45In this first scan, we have two non-specific granulomas.
12:48We are looking at a family.
12:49Okay?
12:51That's who will be on our operating tables today.
12:53And look, I know it goes without saying, but I want it on record.
12:55There is no room for error.
12:57None.
12:57One mistake and a whole family suffers.
12:59If you're this concerned, maybe we should consider holding a beat.
13:04I'm sorry.
13:05Are you having cold feet?
13:07No.
13:08No.
13:08But I've always had reservations.
13:10You know as well as I do, this is not the standard of care.
13:12Yeah.
13:12Ryan's not a standard case.
13:14Of course not.
13:14But there's a reason that no one does live in donor lung transplants anymore.
13:18We're talking a much higher mortality rate.
13:20Post-op, Vivek and Steven are at risk for bronchial stump leaks, bleeding, diminished lung capacity.
13:25Yeah.
13:26I'm sorry, haven't they been made aware of the risks?
13:29Yes, they have.
13:30But I'm concerned that their understandable desire to save their son is clouding their judgment.
13:35Yeah, but of course it is.
13:36They can't just sit back and watch their kid die.
13:38What happens if we do this and he still dies?
13:41Okay, I just want to make sure that we're thinking this through.
13:43That's all.
13:44I know, but if I knew you weren't all in, I would have gone to someone else.
13:48You didn't really give me a choice.
13:49You'd be hard-pressed to find a cardiothoracic surgeon that can get behind a living lung donation.
13:53Listen, I've been working with Ryan and his parents for months now.
13:57Months.
13:58We are out of time.
13:59We have to take a swing.
14:00That is it.
14:00I'm the one who's been seeing his health decline on ECMO every day.
14:04Calling Yunos multiple times.
14:05Hold on, hold on.
14:06Let's...
14:07We can debate this all day long.
14:09The only people who can really make the decision are Ryan's dads.
14:13So, why don't I...
14:16We...
14:16Go speak to them.
14:17Okay, I'm coming too.
14:18No, no.
14:19You should stay here, get some air, and I will fill you in.
14:22Okay.
14:30Switch services with me?
14:32No.
14:32Oh, the plastic fellow hates me.
14:34What did you do?
14:35Why do you assume I did something?
14:37Because it's you.
14:38Well, I heard your boyfriend's working with your other boyfriend.
14:40Were you talking around before you told me?
14:42We lived together.
14:43Yeah, yeah, yeah.
14:43I knew first.
14:44You should be mad at her.
14:45Hey, switch with me so you don't have to work together.
14:47I'm not interested.
14:47But I've got my own problems.
14:52Dr. Seid, call recovery.
14:53Dr. Seid, call recovery.
14:55Is it time?
14:56Not quite yet.
14:57This is Dr. Gray.
14:58She'll be joining your surgical team.
15:00It's nice to meet both of you.
15:01I know you've been made aware of the risks of your surgeries.
15:05But I'm new to the team.
15:07So, I just wanted to make sure that we're all on the same page here.
15:11We're in no matter the risks.
15:12That's the page we're on.
15:14Okay.
15:14You understand that you'll both likely have diminished lung capacity
15:17for the rest of your lives.
15:18I hate exercise.
15:19But you could have bleeding.
15:20You could need more surgeries.
15:22Develop infections.
15:23We have insurance.
15:24You could have a stroke.
15:25Nothing that could happen to me would be worse than losing my son.
15:29Ryan was two when we met.
15:30Can't really explain this as daddy's boyfriend to a two-year-old.
15:34I was just a man who was around sometimes and gave him snacks.
15:39But one night, the power went out and Ryan panicked and ran into my arms and I realized he trusted
15:47me.
15:48He felt safe with me.
15:50I couldn't tell you when it happened or how, but that was his dad.
15:58I felt helpless watching him suffer.
16:01If I can take that away, you're giving me the greatest gifts.
16:08Well, he's lucky to have you both.
16:10I'll let the team know we're good to go.
16:11All right?
16:13Okay.
16:23Hey, uh, I need to give you a heads up.
16:25If it's that I'm working with a boyfriend you cheated on, you're too late.
16:28I didn't cheat.
16:30We were broken up then and now.
16:32Yeah, well, he's acting like the two of you are married and then he walked in on us at the
16:35bar.
16:35We agreed that never happened.
16:36Yeah, well, he didn't.
16:37And he's pretty pissed for somebody who you're not with.
16:39Wes, it's over.
16:41I swear.
16:44That guy's a piece of work.
16:45Hey, where are you going?
16:46I'm going to go tell him I'm done putting up with this crap.
16:54Dr. Reeves to pediatrics.
16:55Dr. Carol Reeves to pediatrics.
17:04Oh.
17:04Oh.
17:07Sorry.
17:07I, uh, didn't mean to creep up on you.
17:10It's all right.
17:11I was getting in the zone.
17:13You always blast music before your surgeries?
17:16Yeah, I used to.
17:18Yeah.
17:19Now I just kind of save it for the scary ones.
17:23You're nervous?
17:26You know we're doing a living donor lung transplant today, right?
17:30Yeah, but you built a new aorta.
17:32You can do anything.
17:33What's up?
17:34A little luck and a lot of Dr. Allman.
17:36Do you really feel that way?
17:38I know I'm good at my job.
17:39I'm not fishing for compliments.
17:42But when you sign on to a risky surgery that you've never done before, you don't really know if you
17:48have what it takes until you succeed or fail.
17:52Yeah, I just, I don't want to fail today.
17:56You're a terrible surgeon.
17:58Okay, thank you for that little confidence.
18:00Didn't let me finish.
18:02Do I want to?
18:03You don't have a God complex like every other surgeon, myself included.
18:08You know your limits and you don't push it.
18:11If you hit a wall, you go around it.
18:14And that's why you won't fail.
18:16You're not in this to prove something.
18:18You're, you're just trying to be a good doctor.
18:22That did get better.
18:24Hmm.
18:27I'll be right.
18:31The reality is, is that no one can tell you whether or not to be together.
18:34That is between you two.
18:37Where's your intern?
18:38No, I've paid him twice.
18:40Hey, we need to get straight on something.
18:42I never knew.
18:43There he is.
18:44Okay, yeah, I gotta go.
18:45We will talk in our session next week.
18:47All right, bye-bye.
18:48I am so sorry, client emergency.
18:51Hope they work things out.
18:53Well, honestly, they should call it, but they can't quit one another, so.
18:57How were my scans?
18:59They show bleeding in the spleen.
19:01That was the fluid we saw in the ultrasound.
19:04Was there a spleen band-aid for that?
19:07Unfortunately, no.
19:08We will have to remove it surgically.
19:11What about chemo?
19:12Is this going to interrupt my treatment schedule?
19:14Do you see my face?
19:17You're not worried.
19:18No, but I will be if you don't let us remove your spleen.
19:23Okay, yeah, I was really hoping chemo and I would work out.
19:26Yeah, me too, but let's take care of this first.
19:33Okay, there's a lot of moving pieces today, so let's go over the plan one more time.
19:37Njugu, Griffith, and Millen will be here on Team Ryan.
19:40Once they've prepped him for the grafts, Dr. Gray and I will open Vivek.
19:43As we prep the right lobe, Dr. Weber and Dr. Warren will procure Stephen's left lobe.
19:48We'll all meet back here at the end.
19:50Any questions?
19:52I'm ready.
19:52Let's go.
19:53Okay.
19:54Good luck, everybody.
20:04Scalpel.
20:15Virtual personal assistant in the car?
20:17No, that's a car I get a living.
20:19Stop talking about how much you love this car.
20:22You've got to, like, you know, just play it cool.
20:23I can do that.
20:24I can be cool.
20:25Look how cool I'm being right now.
20:27All right, you know what?
20:28Let me do the talking.
20:30Here you are.
20:33Joe, what are you thinking?
20:35Ready to move forward?
20:36Oh, definitely.
20:37It has everything we need.
20:38The three rows are just so...
20:40But there are factors that I'm factoring in.
20:45Let's talk about his tax.
20:46What's your bottom line?
20:49My manager says I can give you a $1,000 credit.
20:56How does this look to you?
21:00We both know you can do better than this.
21:03Joe is a loyal customer.
21:04Very loyal.
21:05I mean, she's about to have twins.
21:07She can't take on this kind of car payment.
21:09I don't know your financial situation, but I can tell you people grossly under budget for cars.
21:15They think it's just rubber and metal, and it's not worth the hard-earned money.
21:18But this isn't just a car.
21:20This is your children's lives.
21:22It's their memories.
21:25Family road trips.
21:26Neighborhood carpool.
21:28Driving to soccer games.
21:30Your kids are going to grow up in this car.
21:33That's worth something.
21:35No?
21:37I'm sorry.
21:38I just, uh, I need a minute.
21:41Uh, she's a surgeon.
21:43That's probably a very important call.
21:45I'll be right back.
21:46Sorry.
21:46I'm sorry.
22:14hey what's happening is that negotiating tactic you are so good we
22:21never took a family road trip I mean we wanted to go to Alaska with the kids but
22:25we just kept harshing it off you can still go but not as a whole family
22:36Owen and I are getting a divorce oh Teddy I am so sorry no it was my choice
22:44but it's just now the kids will never have that memory instead they're bumping
22:52into cast back men and eating strange pizza without me well what good are family
22:58memories with a miserable mom your kids deserve the best version of you but I'm
23:04not I'm not the best version of me this morning I was crying in the shower just
23:11thinking about selling the house and and tonight Owen is going to be with the
23:15kids while I'm in a hotel room eating room service and watching dumb reality TV
23:25that doesn't sound so bad
23:31well Kyle loses its luster after three nights in one week
23:39I've been divorced it's not like flipping a switch takes time to find your footing when you do it is
23:49so
23:49worth it I'm happier now than I have ever been I don't know what makes me happy anymore
23:57well you don't have to transform your life overnight start small put yourself first for once and then find one
24:08tiny moment of joy
24:22anywhere from Marsh oh not yet you know you could have held off on scrolling in yeah I'd rather get
24:28the patient prepped don't want to be the holdup
24:33see that him oh no that's yours
24:39um do you mind
24:45Paulette lost her phone if you need her text cards
24:50um
24:54Fukushima's great aunt passed she'd like next weekend off
24:57a whole weekend for a great aunt I mean I'm sorry for her laws
25:03you want me to check I want you to make it stop
25:06well that I can do
25:08silent
25:10you know that doesn't make the work go away right
25:12chief to chief it's called punting
25:27did you do the post-op check on Alex Broco she's on SBT she should be ready to wake up
25:32soon and face reality unlike other people what the hell is that supposed to mean I talked to Griffith she
25:36said you guys were over then and now
25:38our words I'm not talking about this with you and I'm not gonna let your bruise of ego ruin my
25:42career I don't need to get in your way you can ruin it all on your own ready to go
25:45well Katie deserves all our focus
26:02is Bailey worried about soccer tryouts is he fighting with a friend is it guy stuff Meredith
26:10hey I'm just asking uh Ryan is on bypass and he's stable thanks Dr. Millen let us know if there's
26:16any changes
26:17okay here we go okay scalpel we need to move quickly and efficiently wait he's febrile
26:26102.1 what was his white blood cell count from this morning 11.1 okay sporter line I can't remove
26:33part of his lung if he's fighting an infection let's reset the probe and recheck his tent please
26:39well it's not gonna matter if his white count is borderline the ride is running out of time
26:43Becker will want us to do everything we can recheck the temp again please
26:47still 102.1
26:50we should postpone for a few days that's what Ryan has a few days surgery's off get him out of
26:54here
27:04she just means a minute I thought the car was for you it is yeah it's for me and my
27:12kids
27:16um do you have kids no back to the car I thought you liked it I loved it I uh
27:24I think it's fine
27:26I wish the price was more negotiable but all right Dan can I call you Dan
27:31uh I prefer Daniel we are busy people Dan I'm sure that you've got a lot going on too so
27:37let's make this
27:37quick she wants this car but she also wants to be able to pay for college someday for her kids
27:42so if you want the sale we will take the card MSRP uh no market adjustment fee no preparation fee
27:50and uh we're declining the extended warranty
27:54I'm only authorized to take the price down fifteen hundred dollars
27:57an hour ago that was a thousand so you can see why I'm skeptical
28:02uh like I said everybody wants this car
28:06well then you're just gonna have to sell it to one of them thank you so much for your time
28:11uh I'm sorry
28:14what are you doing I am finding my joy
28:16uh I can run the numbers again maybe there's a compromise
28:21we're listening
28:27you paged
28:29Mr. Lee's developed a hematoma
28:30I need you to book an OR so we can drain and evaluate the skin graft
28:34another surgery?
28:35Dr. Kwon will get you prepped
28:36wait we're taking him now?
28:38we have to control the bleeders ASAP
28:39you have a problem with that?
28:40he just ate lunch
28:42he's NPO he can't have anything
28:45who lifted the order?
28:47I did his surgery was done it had been ours
28:49he's on warfarin which made him a risk for a rebleed
28:51that's why the NPO wasn't lifted
28:53you'd have known if you'd bothered to ask
28:57call anesthesia and see what they're comfortable with
28:59this could be a long night
29:03Ryan this is the worst case scenario
29:05I know
29:06I got Ryan off ECMO
29:07got him intubated
29:08put him on bypass
29:09and now I gotta get him off bypass
29:10and back on ECMO?
29:11I told whoever this surgery is off
29:13okay
29:13look we'll push it a few days
29:15you suggested it yourself earlier
29:16that was before we took him off ECMO
29:18Ryan is six years old
29:20six
29:20his lungs can't handle the back and forth
29:22he's too small
29:25what if he could live with one lobe instead of two?
29:27well his heart could fail if he only has lung tissue on one side
29:31are you thinking we split Steven's right lower lobe into two?
29:34isn't that what you do with livers?
29:36this isn't the same
29:37yeah but could you do it?
29:38is it possible without destroying the remaining lobe segments?
29:47uh hold on
29:49um
29:51yeah well the ratio would have to be less than 200%
30:06yeah the math checks out
30:07so then I should tell Weber the surgery is back on?
30:10well no no because that doesn't mean that I can pull it off
30:12the orientation of the vasculature would be reversed
30:18so if we split the lobe into two halves
30:22then the right side would fit into the right side of his chest cavity without a problem
30:25but for the left we would need to invert it to match the anastomosis
30:32and that could work?
30:36yeah that could work
30:37let's try it
30:38okay great let's go
30:39okay
30:44dissection looks good
30:46next plane is almost free
30:48I lost visualization
30:51you can just tell me when you want me to move it
30:53that was easier
30:55uh how about walking your intern through the next steps?
31:00first we identify the splenic artery and the veins
31:04then we clamp and divide them to free up the spleen to send to path
31:08then we ligate the vessels ready for specimen
31:12that's your cue to hand me the mets
31:18alright
31:22okay
31:29make sure you have good hemostasis
31:32suction is clogged
31:33use some saline to clear the line
31:44hang on Brian
31:45will you take the spleen to path and put in a stat order for me?
31:50darling?
31:50mmhmm
31:54I'll take that and 2-0 silk please
31:56I'm not done
31:56you are now
32:00take over the retractor
32:05no
32:11no
32:16no
32:17no
32:31With your feet on the air and your head on the ground
32:39Try this trick, spin it, yeah
32:46Your head will collapse, and there's nothing in it
32:51And you'll ask yourself, where is my mind?
33:00Way out in the water, see it swimming
33:12I was swimming in the Caribbean
33:20Animals were hiding behind the rocks
33:24Except a little fish bumped into me
33:29Where you're trying to talk to me, quick, quick
33:32Where is my mind?
33:40Way out in the water, see it swimming
34:03Good job, everyone
34:04We did it
34:05We saved the family today
34:14Good hemostasis in this stuff
34:16Okay, so let's pack her and check the other quadrants before we close
34:22Lap packs
34:26I don't know what is going on with you and Bryant, but it has to stop
34:30Dr. Bailey
34:31What I do know is that you've already been kicked out of an OR once this month
34:36And whatever it is, has been impacting and affecting patients
34:40Including this poor woman, who sure as hell has been through enough
34:44I can't have it
34:46Am I clear?
34:47Yes, but
34:47Am I clear?
34:49It's Katie's liver
34:50Do these look like tumors?
35:13You sure you don't want a ride?
35:15I could use the air
35:16Well, thank you, again
35:17And it does get better, Teddy
35:20You just have to give yourself permission to feel happy again
35:28Is there anything else I can do for you?
35:31I hear your voice late into the night
35:38Say all the things we never made right
35:45How are you feeling?
35:48I'm tired
35:49What a week
35:50That makes sense
35:52You have an infection
35:53You expect a fever in the OR
35:55We weren't able to take your lobe
35:57What about Ryan?
35:58He's doing great
35:59We were able to make two lungs from your husband's one lobe
36:01He's going to be okay?
36:03Uh-huh
36:06Thank you
36:08Thank you for saving my son
36:15Did you clean an order for the close-up labs?
36:17Yep, for first day in the morning
36:19We should get a set now
36:20Okay, sorry I can do that right now
36:24Look, I only ask because I got it wrong my first time
36:35Ah, look who's back
36:39How'd it go?
36:40Is my spleen okay?
36:42She'd tell her it wasn't her, it was me
36:43The operation went smoothly
36:46And, um, when can I get back to work?
36:48Uh, you still got arrested for a few days
36:50Hopefully your clients will understand
36:52Thank you
36:53This morning was pretty scary
36:54And I was kind of freaked out by the whole spleen thing
36:57But I'm grateful that you guys were able to fix it
36:59And I can get back the cancer treatment
37:04Oh, don't worry
37:05I know
37:05It's one day at a time
37:14What's wrong?
37:16So, while we were operating
37:19We found areas on your liver
37:23That are concerning for metastasis
37:25The cancer spread
37:29I-I thought Dr. Sugihara
37:32He said that the chemo was working
37:35How bad is it?
37:37Well, okay, we won't know
37:38Until we get the biopsy results
37:40And we need new scans to restage you
37:45If you had to guess
37:50Never mind
37:51I could see it on your face
37:53You're worried
37:56It's over
37:58Isn't it?
38:03No
38:04As long as you're still here
38:06Nothing's over
38:08He is right
38:11Get some rest
38:12And we'll talk more tomorrow
38:17The beauty of the rainbow
38:29Anesthesia said Ray should be ready by 9.30
38:32Great
38:34Your noodles look great
38:38I'm supposed to be on a date
38:39At Nicoletti's right now
38:43Yeah
38:45Look, I think we got off on the wrong foot
38:47And I admit
38:48It was totally my fault
38:49And I'm sorry
38:50But aside from the occasional social faux pas
38:52I'm a pretty great resident
38:53I'm highly skilled
38:54I'm good at taking direction
38:55And I'm very interested
38:57In a plastic specialty
38:58Tell me what I need to do
39:00To have another chance
39:01To impress you
39:02And I will do it
39:03Anything at all
39:04Stop talking
39:09Copy that
39:13Dr. Sellers
39:14Forces 1-9
39:15Dr. Monty Sellers
39:16I'm in
39:17In what?
39:19The pact
39:19I'm in
39:22I thought you didn't need the pact
39:24Just
39:25You know, being proactive
39:26Can't hurt
39:28Ryan's off pressures
39:29We'll be able to wean him off ECMO
39:30In the next 48 hours
39:31He's doing great
39:32That's amazing
39:33Can you do a post-op check on him
39:34Before you go
39:35Of course
39:37Oh, uh, Nolan
39:39Thanks for the pep talk
39:41Anytime
39:45What pep talk?
39:47That's nothing
39:49I'm gonna check on Ryan
39:52Anything can be a race against the clock
39:54If you let it
39:56Waiting for a promotion
39:57Having a child
39:59Eating the last yogurt
40:00In your refrigerator
40:02Oh
40:05Hey
40:05You, uh
40:06You okay?
40:08I think my patient
40:09Has terminal cancer
40:10And she's 27
40:13That's tough
40:14I'm sorry
40:17Um
40:18You gonna be a while
40:21Looks that way
40:23Uh, I will pick up Prue
40:28Oh
40:29Oh, and what brings you here?
40:33Dropping off some items
40:34To Warren
40:37I'll see you at home
40:40So what are those, uh
40:42Intern payroll forms?
40:43Insurance reimbursements
40:45Oh
40:45Chief President has to do insurance too?
40:48No
40:48Chief of Surgery does
40:50Oh
40:52Is your wife always right?
40:54I find it's always easiest
40:55To assume yes
40:58Sometimes you really are running out of time
41:02Most of the time
41:03It's all in your head
41:04Hey
41:05Turns out Levec had a sinus infection
41:07Ah
41:07He's gonna be okay
41:08Good
41:10Thank you for hanging in there with me today
41:12You know I don't give up that easily
41:14That's an understatement
41:15And I don't need you to tell me what's going on with Bailey
41:18What is this?
41:19Are you trying reverse psychology now?
41:21No
41:21It is not
41:22I think it's great that my kids trust you enough to share things with you
41:25You know I love those kids
41:26I know
41:27Come on, let's go
41:28And when you let go of all that fear
41:59Where do I go, you?
42:04The possibilities are infinite
42:07I know
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